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Torticollis

Definition

Torticollis affects the ability to control neck muscles from contracting. This causes the head to turn and tilt to one side, and the chin to point to the opposite side. Sometimes one shoulder is lifted. The muscle contraction may be constant or may come and go.

Causes

The causes of torticollis are not well understood. Causes may include:

Torticollis ranges from mild to severe. It usually progresses slowly for 1-5 years, and then stays the same. However, torticollis may last for life and can result in limited movement and deformed posture.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Your doctor may need pictures of structures inside your body. This can be done with:

Treatment

The treatment for torticollis depends on whether it is
congenital
or acquired. Treatment generally centers on physical therapy, oral medication, botulinum toxin injections, and surgery. Possible treatments may include:

Congenital Torticollis

Stretching exercises several times each day

In some situations, surgery to lengthen the tendon

Acquired Torticollis

Identifying the cause

Physical therapy, especially when used with botulinum toxin, to help relax the muscle and reduce pain

In some situations, surgery to cut the nerve to the muscle that is in spasm

Deep brain stimulation surgery

Certain oral medications, such as pain medication and muscle relaxants

Injections

Injection of
botulinum toxin
to weaken or partially paralyze the muscle—This may help improve neck posture, but only if begun soon after torticollis begins. The drug's effect wears off after several months and treatment must be repeated.

Injection of alcohol or phenol to deaden the nerve that causes the muscle contraction

Prevention

There are no guidelines to prevent torticollis. Early treatment may help keep the symptoms from worsening.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.